Symptoms
You’ll normally feel numbness down the insides of the third and fourth toes, and pain under the ball of the foot which gets worse as you run. Although it may feel like walking on pebbles in shoes it is often relieved when barefoot. You’ll experience acute pain if you compress the sides of the foot together.
Signs
Your transverse arch has usually become flattened, bringing the heads of your metatarsals (midfoot bones) together and compressing the nerve between them, causing swelling of the nerve along with the pain.
What else could it be?
Pain over the metatarsal heads (metatarsalgia), a stress fracture of the bone, or tendinitis may mimic the pain, while conditions varying from diabetes to multiple sclerosis could cause the numbness.
Self-treatment
Raising the transverse arch of the foot with a metatarsal arch support can separate the bones and free the pressure on the nerve, which may recover. Wearing wide-fitting or loose-laced shoes can help, while partial rest becomes a painful necessity.
Medical treatment
If conservative measures with non-steroidal anti-inflammatories (eg ibuprofen) fail, a steroid cortisone injection may reduce the inflammation. Many cases require surgery to remove the damaged, swollen and inflamed nerve.
Can you run through it?
Ignore the symptoms at your peril. If you leave the condition until surgery is required, you’re likely to lose a full month from your running schedule.
Recovery time
If the condition is caught early and appropriate measures taken, there should be minimal upset.
Hi Kate,
I too have had similar problems. I don't know whether you've had proper advice yet, but if it is the ball of the great toe, that you are getting the pain from the small sesamoid bone which run in the split tendons of a small muscle (flexor hallucis brevis).
Fortunately, when I had this problem, rest, and softer cushioning have more or less resolved the problem for me. I imagine exercises for the intrinsic foot muscles, such as toe press-ups could help in the long run.
If you havenit yet, do see a podiatrist who can relieve the problem by customising footwear, or by simply putting felt around the area to prevet your weight being taken on the painful area.
Good luck,
Mowgli.
Posted: 19/08/2002 at 20:45
